1268 When scars don’t let you sleep- unusual case of Restless Legs Syndrome secondary to Keloids

Abstract

Abstract Introduction Restless leg syndrome(RLS) is a common disorder which has been estimated to be present in 5 – 15% of the general population with 2.5 % requiring intervention. RLS can be primary or secondary. Secondary RLS usually develops later in life and is associated with another disorder like chronic kidney disease, iron deficiency, spinal cord disease, or varicose veins. Keloids have never been reported to be the cause of RLS. Report of Case 50 y.o female with hypertension and diabetes presented for evaluation of loud snoring and witnessed apneas. Prior to the visit she underwent a sleep study that showed she had moderate sleep apnea (AHI 15). She also reported having a painful sensation in her legs mainly at night affecting the skin on her calves. The painful sensation gave her an urge to move her legs. Moving or rubbing her legs helped relieve the painful sensation partially. She did not have these symptoms during the day. The symptoms started in the summer of 2018 after she started having keloids on her calves. Keloids followed the course of her varicose veins and the keloids progressed over the last year. Her RLS symptoms were less bothersome when the keloids were smaller. When she has taken tramadol and oxycodone in the past for other pains, she noticed that her painful RLS symptoms were completely eliminated. She was taking gabapentin 600 mg at bedtime for neuropathic pain which hasn’t helped her RLS symptoms. On physical exam, major keloids were seen bilaterally on her calves. Her OSA with treated with CPAP and she was also asked to increase her gabapentin from 600 mg to 1200 mg for her restless legs. Conclusion This is one of the first reported cases of RLS secondary to keloids. Whether treatment of keloids would help relieve RLS symptoms is unknown.